REGISTRATION FORM Reg. No.

To be Filled by NTS

Government of the Punjab Picture 1

NTS PRIMARY & SECONDARY Paste your recent
passport size color
HEALTHCARE DEPARTMENT photograph with gum
Transition Support Unit (TSU)
Screening Test for the post of

Eligibility Criteria:
Support Coordinator C
A. Is your Age according to the desired Post at the date of 18-01-2017? Yes No

B. Is your Qualification / Experience according to the required post? Yes No

C. Are you Domiciled in Punjab? Yes No

If your reply is “Yes” to A, B & C above, only then please proceed further. Otherwise you are not eligible to apply.

01. Bank Online Deposit of Rs: 500/- from Designated Bank Branches.
Bank Code Deposit Date

*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy)

Personal Information: Use CAPITAL letters and leave spaces between words.
02. Name in Full:

03. Father’s Name:

04. Candidate CNIC #:

Write your own CNIC No. Or B Form No.

06. Date of Birth: D D M M Y Y

05. Gender: Male Female Write your Correct Date of Birth
otherwise you will be rejected 1 9
07. Postal Address:
All correspondence will be made on this address though courier service or ordinary postal service.

City: District:

08. Phone No: (OFF) (RES.) (Mobile)

City Code - Phone No DO NOT give your portable mobile number (which is converted
from one network to another) so that SMS delivery is ensured.

09. Are you a Government Servant and applying through proper channel?
In case of Yes, please attach NOC
Yes No

10. Are you a Disabled Person?

If yes, please attach Disability Certificate Yes No

If Non Muslim,
11. Religion: Muslim Non Muslim Please Specify:

12. Test City: Lahore

Page 01 |
C
 13. District of Domicile: Fill Only One Box (Mandatory)

01. Attock 02. Bahawalnagar 03. Bahawalpur 04. Bhakkar

05. Chakwal 06. Chiniot 07. Dera Ghazi Khan 08. Faisalabad

09. Gujranwala 10. Gujrat 11. Hafizabad 12. Jhang

13. Jhelum 14. Kasur 15. Khanewal 16. Khushab

17. Lahore 18. Layyah 19. Lodhran 20. Mandi Bahauddin

21. Mianwali 22. Multan 23. Muzaffargarh 24. Nankana Sahib

25. Narowal 26. Okara 27. Pakpattan 28. Rahim Yar Khan

29. Rajanpur 30. Rawalpindi 31. Sahiwal 32. Sargodha

33. Sheikhupura 34. Sialkot 35. Toba Tek Singh 36. Vehari

14. Academic Information: (Please do not attach copies of your academic certificates at this stage)
Note: 1. NTS will not issue Roll No Slips to those who have not filled in their academic record properly.
2. Candidate should convert their grades into marks. (O Level / A Level or any other degree having grade).
3. Write exact degree name & major subject mention in certificate / transcript.
4. Result awaiting candidates are not eligible.

Certificate / Specialization / Year Obtained Marks Total Marks

Degree Title Board / University / Institute
Degree Level Major Subject Passing / CGPA / CGPA

Matric
(10 Years)

Intermediate /
D.A.E
(12 / 13 Years)

Bachelor
(14 Years)

Bachelor (Hons)
/ Master
(16 Years)

MS / M.Phil
(18 Years)

Diploma /
Certificate

Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do hereby solemnly
declare and affirm that I have read and understood the instructions and conditions for appearing in
Picture 2
the NTS Test, and I have filled-up the application form as per instructions given below. In case of Affix your recent
any information contained herein is found at any stage to be missing, untrue, false or forged, my passport size color
candidature can be cancelled at any stage (even after admission, if so revealed later), and I shall be photograph
liable to legal action.
with Stapler

Date: _________ Thumb Impression ____________ Candidate’s Signature ________________

Page 02 |
C
General Instructions / Information:
Ø
Please fill the Application Form properly with complete and correct information / answers.
Ø
Please DO NOT leave any field blank, otherwise your application may not be considered.
Ø
Incorrect, false or forged information may result in cancellation of your candidature at any stage, even after admission,
and also proceeding of a legal action.
Ø
Attach your Two recent Passport Size Photographs, Copy of CNIC and Original Bank Deposit Slip (NTS Copy)
Ø
By Hand submission of Application Form is not allowed.
Ø
Mobile Phones or any Electronic Gadgets are not allowed in Test Center premises.
Ø
Use separate envelope and separate application form for each post you are applying for.
Last date for submission of application form is Wednesday
Ø 18th January, 2017.
th
Applications received on or after Thursday
Ø 19 January, 2017 will be rejected.
Ø
Application should reach NTS office latest by last date of submission of Application Form.
Ø
NTS will not be responsible for late receiving of application through courier / Pakistan Post etc.

Please Send Application Forms to:

HELP LINE:
Primary & Secondary Healthcare
UAN : +92-51-844-444-1
Website : www.nts.org.pk Department - TSU (Project)
National Testing Service
1-E, Street No. 46, Sector I-8/2, Islamabad.

Page 03 |
C
 Building Standards in Educational and Professional Testing Building Standards in Educational and Professional Testing Building Standards in Educational and Professional Testing

NTS COPY BANK COPY STUDENT COPY

Primary & Secondary Healthcare Department - TSU Primary & Secondary Healthcare Department - TSU Primary & Secondary Healthcare Department - TSU
Branch Code: Date: Branch Code: Date: Branch Code: Date:

Branch Name: Branch Name: Branch Name:

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP
(* Please deposit fee in only one bank & tick the relevant bank) (* Please deposit fee in only one bank & tick the relevant bank) (* Please deposit fee in only one bank & tick the relevant bank)

Allied Bank Limited Muslim Commercial Bank Allied Bank Limited Muslim Commercial Bank Allied Bank Limited Muslim Commercial Bank
(Formely: Allied Bank of Pakistan Limited) (Formely: Allied Bank of Pakistan Limited) (Formely: Allied Bank of Pakistan Limited)

A/C A/C A/C A/C A/C A/C

Title: NTS-Pakistan-Collection Title: NTS-Pakistan Title: NTS-Pakistan-Collection Title: NTS-Pakistan Title: NTS-Pakistan-Collection Title: NTS-Pakistan
A/C A/C A/C A/C A/C A/C
No. 0010008325640018 No. 647943831003775 No. 0010008325640018 No. 647943831003775 No. 0010008325640018 No. 647943831003775
Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost

LTD LTD LTD

THE POWER TO LEAD THE POWER TO LEAD THE POWER TO LEAD
Remote Remote Remote
Branch: National Testing Service-Pakistan A/C NTS-Pakistan Branch: National Testing Service-Pakistan A/C NTS-Pakistan Branch: National Testing Service-Pakistan A/C NTS-Pakistan
Title: Title: Title:
A/C A/C A/C A/C A/C A/C
No. 0101820001 No. 17427900464503 No. 0101820001 No. 17427900464503 No. 0101820001 No. 17427900464503
Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost
*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit *Note: *Note:
Slip (NTS Copy) along Application Form to NTS Office 1. Please Stamp both copies of deposit Slip. 1. Please Stamp both copies of deposit Slip.
a 2. The Bank Must Return “NTS Copy” to the Candidate. 2. The Bank Must Return “NTS Copy” to the Candidate.
Application Form will not be entertained without Original Deposit Slip (NTS Copy)
3. Deposit Slip will not accepted without Candidate CNIC/ B Form No. 3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.

Applicant’s Applicant’s Applicant’s

Name: Name: Name:
Father Father Father
Name: Name: Name:
CNIC No/ CNIC No/ CNIC No/
B Form No: B Form No: B Form No:

Post Name: Post Name: Post Name:

Amount
500/- Amount in Five Hundred Rupees Only Amount 500/- Amount in Five Hundred Rupees Only Amount 500/- Amount in Five Hundred Rupees Only
Rs: word: Rs. Non Refundable/ Non Transferable Rs: word: Rs. Non Refundable/ Non Transferable Rs: word: Rs. Non Refundable/ Non Transferable

Applicant Signature Cashier Officer Applicant Signature Cashier Officer Applicant Signature Cashier Officer